This chapter highlights some of the current health programs and policies in place and changes in demographic trends for older adults living within American society. In addition, substantial changes within the social, political, and cultural expectations of communities over the past century pose challenges for policies and programs serving older adults. The chapter presents several issues emerge as realities within the context of policy development and program planning for older adults. These issues include changes in living arrangements, education levels, economic well-being, and rural population settings; trends in morbidity and mortality; and changes within the social, political, and cultural expectations of communities. Despite the availability of programs and services resulting from health policies, many programs have focused upon “medically necessary” services and have lacked a health promotion, health education, or community-based focus.
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- Go to chapter: Background and Demographic Profile of People Growing Older and/or People With Disabilities
This chapter helps the reader to be familiar with the role coalitions play in advocacy and policy development and to understand the various types of coalitions that affect the policy landscape. It also helps the reader to be familiar with the various roles that exist within groups and coalitions that contribute to the success or non-success of the group process. A number of strategies can be used to develop initiatives to impact one’s advocacy efforts. These strategies can be used to promote the development of new programs and services and can include the use of and/or development of coalitions, the media and media advocacy, and consumer advocates. The chapter addresses each of these strategies in greater depth. It outlines a variety of issues related to coalitions, group development, and coalition building for aging policies and programs.
This chapter focuses on sources of evidence for evidence-based policy development. It explores some of the dilemmas with developing an evidence base and provides a range of empirical sources within the aging and disabilities arenas that can be used in building an evidence-based approach to policy development. The journey, however, will not be without struggle—since philosophical paradigms, and social and economic factors will interface and play a role in the development of evidence-based policy. The chapter helps the reader to be aware of healthy people 2020 benchmarks that are used to guide program planning and policy development. Benchmarks currently have been established in order to identify where health goals for the nation and individual states should be, and the program is evaluated routinely by local and state health departments. Healthy people 2020 is also used to gauge the impact of health policy.
This chapter helps the reader to understand how to use tools such as health behavior models, the media, coalitions, and needs assessments to bring a vision to fruition and how to use advocacy tools for policy and program development. It also helps them to understand how to use advocacy tools to influence the practice arena for older adults and people with disabilities. The chapter reviews the various tools and strategies, along with policies that have been addressed thus far, and integrate these issues and skills with one’s vision for either program planning or policy development. When considering program development, all tools and strategies related to policy development apply equally. Some additional strategies or tools to use for program development include the health behavior models. This chapter attempts to integrate the theories and concepts and suggest how a program planner or policy advocate can apply them.
This chapter explores health promotion frameworks, to showcase their role vis-à-vis health policy and programs, and discusses three specific frameworks. Health promotion frameworks are theoretical conceptions of how health behavior can be addressed. These frameworks are conceives for the purpose of program and policy development. The health promotion frameworks are the health belief model (HBM), the theory of reasoned action, the transtheoretical model of stages of change. This chapter addresses these three questions; however, prior to discussing these questions and answers, it is essential to understand some well-known health promotion frameworks. Although a number of health promotion frameworks exist in the literature. It focuses on three that can be specifically applied to older adults. The chapter showcases use of health promotion frameworks in the program planning process for older adults can have a number of positive outcomes.
This chapter presents a brief overview of some legislative efforts within the mental health (MH) arena and examined their limitations and application with respect to older adults and people living with mental illness. The chapter also takes us through a journey to examine the current status of MH and older adults, with a particular emphasis on depression, anxiety, and schizophrenia. It discusses and reviews the programs, services and issues still outstanding within the MH arena. The chapter helps the reader to understand specific components of the Community Mental Health Act and other MH-related legislation. Many of the community day hospital programs and community MH programs administered through the Community Mental Health Act are based on the deinstitutionalization paradigm since the goal is to treat people outside the institution and within community settings. It concludes with laying out some challenges for the future in the area of MH and older adults.
Aging policy is shaped by a variety of demographic, social, and economic factors. However, these factors are not the only influences on the development of public policy or aging/disability policies. Philosophical paradigms and theoretical frameworks also influence the actual development of policy and play a strong implicit role in how public policy is drafted. Values and philosophies guide the development of specific philosophical paradigms and shape how aging and disability policy is developed and implemented. This chapter explores how these realities play a role in the development and implementation of public policy and aging/disability policy. It showcases some of the realities that may prevent the implementation of the policy or program as envisioned. As a safeguard against a subjectively devised policy and program base, objective evidence and empirically driven initiatives can be developed by aging and disability policy advocates.
Policy and Program Planning for Older Adults and People With Disabilities, 2nd Edition:Practice Realities and Visions
This book attempts to build students’ understanding of policy development through a critical analysis and review of policy frameworks, and the policy implementation process. The book is organized into four parts comprising twenty-one chapters. Part one of this book lays out a background as to the current and future demographic trends of older adults and makes the case for the reader that there are a variety of philosophical, political, economic, and social factors that affect public policy development. The chapters help the reader to explore a range of perspectives that define, shape, and impact the development and implementation of public policy. It intends to prepare the reader to critically analyze public policies related to aging. Part two provides an overview to major federal policies and programs that impact older adults and people with disabilities. It examines some historical developments leading up to the actual development and implementation of the policies. Policies include social security, medicare, the Older Americans Act, and the Americans with Disabilities Act, the Community Mental Health Centers Act, and Freedom Initiative. The last part of the book outlines specific programmatic areas that flow from aging policies, and specific components that flow from federally mandated policies. Each chapter contains same basic outline: an overview of the programs, specific features and strengths of the programs, gaps and areas for development, and challenges for the future.
- Go to chapter: Social, Political, Economic, and Demographic Factors and Historical Landmarks Impacting Aging and Disability Public Policy
Social, Political, Economic, and Demographic Factors and Historical Landmarks Impacting Aging and Disability Public Policy
This chapter helps the reader to be familiar with the demographic and social factors that influence and shape aging and disability policy over time and to be aware of policy changes over the past century within disability and aging public policy. It explains the contrast between advances in science and technology and public policy related to people growing older and people with disabilities. Landmarks serve as essential tools to help us recall specific historical events in time. Historical landmarks, science, and technology have played significant roles in the evolution of social policies; however, aging and disability policies may not have made as many strides as other areas throughout history. The chapter briefly discusses: the role of historical landmarks in shaping social trends and public policies; the relationship between historical landmarks and aging and disability-related policies; and trends in policy, social, and political influences and landmarks in the United States.